Q I have asthma and my symptoms are worse when I get heartburn. Could the problems be linked?

CL from Hove, East Sussex

A Yes, they could. Acid reflux is when stomach acid travels into the gullet and throat. This causes heartburn and dyspepsia but can also trigger other problems such as hoarseness, a cough and even asthma. The prevalence of acid reflux in asthma sufferers has been found to be as high as 80% in some studies. It is not clear whether acid reflux predisposes the sufferer to asthma or if asthma treatments cause the reflux. However, many people report that their asthma improves once their reflux is controlled with medication such as proton pump inhibitors, so consult your doctor.

Q I’ve heard that the implant version of Antabuse is not available through the NHS. Can it be found by going private?

MS from Kirkcaldy, Fife

A These implants are sometimes used to treat serious alcoholism. They are fitted under the skin above the stomach and release a constant amount of the drug disulfiram. This blocks the normal breakdown of alcohol in the body, which causes a poisonous intermediate product called acetaldehyde to build up if alcohol is drunk by the patient. Small amounts cause headaches and vomiting.

The implants are sometimes fitted in private clinics but you will need to be thoroughly vetted. Discuss your reasons for wanting the treatment with your GP as the drug can be prescribed in tablet form if appropriate.

Q I am in my early thirties and appear to have developed varicose veins in one leg. Can these occur at my age?

IC from Dover

A Yes, they can. Varicose veins happen when the one-way valves of the leg veins stop working properly and the whole vein comes under pressure from the weight of the column of blood above it. This stretches the thin walls of the vein and causes the characteristic appearance of varicose veins.

The usual symptom is discomfort if standing for long periods. Treatment includes support stockings, exercise and – if severe enough – surgery. There are strict criteria for this surgery on the NHS, so ask your doctor for an accurate diagnosis.

Write, with your initials and home town, to drknow@sunday-times.co.uk. All questions are answered by a practising doctor

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